Injections are an important part of diabetes care for many individuals, yet it is quite common for people required to inject insulin on a daily basis to experience a wide range of emotions and concerns surrounding the act of taking injections, including anxiety, discomfort or a feeling of failure. For some this anxiety is minor, for other patients it can be quite significant. Regardless of the degree of burden, it is important to address these psychosocial issues with your patients.

Often inaccurately referred to as “needle phobic,” these patients may have accepted any pain, bruising or quality of life issues associated with injections as something they need to live with and therefore may feel the issue is not worth mentioning, or may feel embarrassed to admit to the issues during the appointments they have with their healthcare provider. Conversely, some patients may not mention their concerns regarding their injections, because they have taken it upon themselves to “manage” the situation (i.e., adjust their eating, fast or alter their dosage).

Regardless of the circumstances, these patients have chosen to keep any issues to themselves rather than address them. However, the key to successful treatment is having an active and engaged patient. With that in mind, here are some things to consider when initiating a conversation with your patients about the burden of their injections:

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Encourage your patients to prepare questions and notes in advance for their appointment so that issues may be addressed in a timely fashion. Also encourage them to prepare a quick diary of their meals and insulin injections for the week prior to their appointment to bring with them.

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Developing a patient program to improve diabetes care in your practice can also help. Some suggestions include:

Establish patient support groups that allow people taking insulin injections to discuss

quality of life and offer suggestions to each other1A

If you are a physician, work with a diabetes educator who can implement a program

that a patient can follow in learning effective diabetes self-care, including discussion

of the emotional impact of diabetes1B

Encourage family involvement in diabetes self-management by holding talks/

meetings with family members about diabetes injections

My injections are not painful, but they are a hassle and impact my daily life. Is there

a way to make them easier to deal with?

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A common belief of patients is that taking injections for their diabetes is a personal failure; that they did not effectively take care of themselves through other means of treatment or diet and exercise. It may help to reiterate to your patients that taking insulin is just another means of treating diabetes, and that the condition is chronic and progressive. They did not fail their other treatments, the treatments failed them.1C If they continued to be concerned about this issue, encourage them to seek additional counseling.

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If you are a physician and your patient needs additional injection counseling, encourage them to visit a diabetes educator who can guide them in greater detail on how to manage their injections. If you are a diabetes educator, encourage your patients to speak with both you and the treating physician about how injections impact your life.

Patients need continued support to help them maintain effective self-management. Addressing quality of life issues with your patients can help improve both communication and adherence to their insulin therapy, resulting in improved diabetes control.